Hermann Reichenspurner, MD, PhD, Jose A

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Particulate emboli capture by an intra-aortic filter device during cardiac surgery Hermann Reichenspurner, MD, PhD, Jose A. Navia, MD, Gerald Berry, MD, Robert C. Robbins, MD, Denise Barbut, MD, Jeffrey P. Gold, MD, Bruno Reichart, MD The Journal of Thoracic and Cardiovascular Surgery Volume 119, Issue 2, Pages 233-241 (February 2000) DOI: 10.1016/S0022-5223(00)70178-4 Copyright © 2000 Mosby, Inc. Terms and Conditions

Fig. 1 Intra-aortic filtration system composed of a modified 24F arterial perfusion cannula and 120-μm filter (EMBOL-X). The Journal of Thoracic and Cardiovascular Surgery 2000 119, 233-241DOI: (10.1016/S0022-5223(00)70178-4) Copyright © 2000 Mosby, Inc. Terms and Conditions

Fig. 2 Schematic of Embol-X Arterial Cannula and Filter System within the cardiopulmonary bypass circuit. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 233-241DOI: (10.1016/S0022-5223(00)70178-4) Copyright © 2000 Mosby, Inc. Terms and Conditions

Fig. 3 Particulate emboli found in filter mesh (gross visual examination at 10× magnification). Patient was a 75-year-old man who underwent aortic and mitral valve replacement and thrombus excision from the left atrium. The filter was deployed for 32 minutes. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 233-241DOI: (10.1016/S0022-5223(00)70178-4) Copyright © 2000 Mosby, Inc. Terms and Conditions

Fig. 4 Scanning electron micrograph of filter mesh, showing a relatively clean surface with scattered focal sites of platelet and fibrin (magnification 20×). Patient was a 61-year-old man with 3-vessel disease. The filter was deployed for 26 minutes. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 233-241DOI: (10.1016/S0022-5223(00)70178-4) Copyright © 2000 Mosby, Inc. Terms and Conditions

Fig. 5 Elastica van Gieson stain demonstrating fibrous atheroma. Stain highlights irregularly arranged collagen and elastic fibrils, suggesting fibrous cap or fibrous atheroma containing aggregates of fibrin and fragments of abnormal vessel wall. The patient was a 77-year-old man with 3-vessel disease, and the filter was deployed for 28 minutes. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 233-241DOI: (10.1016/S0022-5223(00)70178-4) Copyright © 2000 Mosby, Inc. Terms and Conditions

Fig. 6 Trichrome stain demonstrating fibrocalcific atheroma. Stain highlights fibrocalcific atherosclerotic wall admixed with fibrous and elastic tissue and microscopic collections of clot and calcium deposits. The patient was a 75-year-old man who underwent aortic and mitral valve replacement, and filter dwell was 32 minutes. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 233-241DOI: (10.1016/S0022-5223(00)70178-4) Copyright © 2000 Mosby, Inc. Terms and Conditions

Fig. 7 Elastica van Gieson stain demonstrating the presence of needle-shaped cholesterol fragments characteristic of the grumous portion of atheromatous plaque. The patient was a 67-year-old man with 3-vessel disease, and the filter was deployed for 30 minutes. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 233-241DOI: (10.1016/S0022-5223(00)70178-4) Copyright © 2000 Mosby, Inc. Terms and Conditions